Bullying

Introduction

This toolkit summarizes content from the Bullying Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

From the MCH Block Grant Guidance. Bullying, particularly among school-age children, is a major public health problem that is associated with a number of behavioral, emotional, and physical adjustment problems. Adolescents who bully others tend to exhibit other defiant and delinquent behaviors, have poor school performance, be more likely to drop-out of school, and are more likely to bring weapons to school. Victims of bullying tend to report feelings of depression, anxiety, low self-esteem, and isolation; poor school performance; suicidal ideation; and suicide attempts. Bullying victims who also perpetrate bullying (i.e., bully-victims) may exhibit the poorest functioning, in comparison with either victims or bullies. Emotional and behavioral problems experienced by victims, bullies, and bully-victims may continue into adulthood and produce long-term negative outcomes, including low self-esteem and self-worth, depression, antisocial behavior, vandalism, drug use and abuse, criminal behavior, gang membership, and suicidal ideation.¹ Children with special health care needs are particularly vulnerable to bullying, with the prevalence of bullying over two times higher for children with special health care needs compared to children without special health care needs.² Dedicated support and prevention strategies are needed to support children and prevent bullying.

Goal. To reduce the percent of adolescents with and without special health care needs who are bullied or who bully others.

Note. Access other related measures in this Population Domain through the Toolkits page.

Detail Sheet: Start with the MCH Block Grant Guidance

GOAL:To increase the percent of children who are physically active.

DEFINITION:
Numerators: Number of adolescents in grades 9 through 12 who report that they are bullied on school property or electronically in the past year (YRBSS) Number of adolescents, ages 12 through 17, with and without special health care needs, who are reported by a parent to have been bullied in the past year (NSCH) Number of adolescents, ages 12 through 17, with and without special health care needs, who are reported by a parent to have bullied others in the past year (NSCH)

Denominators: Number of adolescents in grades 9 through 12 (YRBSS); Number of adolescents ages 12 through 17 (NSCH)

Units: 100
Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE: Related to LGBT Objective 05: Reduce bullying of sexual minority (lesbian, gay, bisexual) high school students. (Baseline: 33.0% in 2017, Target: 25.1%) Related to LGBT Objective D1: Reduce bullying of transgender students. (Developmental)

DATA SOURCES: Youth Risk Behavior Surveillance System (YRBSS); National Survey of Children's Health (NSCH)

MCH POPULATION DOMAIN: Children with Special Health Care Needs or All Adolescents (CSHCN and non-CSHCN)

MEASURE DOMAIN: Social Determinants of Health

1. Accelerate with Evidence—Start with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Chart of Evidence-Linked Strategies and Tools
Evidence-Informed			Evidence-Based
Mixed Evidence	Emerging Evidence	Expert Opinion	Moderate Evidence	Scientifically Rigorous
	Adult-Led Counseling, Mentoring, and Support (2023) Collaboration with School-Based Health Centers (2016) Peer-Led Counseling, Mentoring, and Support (2022) Suicide Prevention In-Class Training (2017) Trauma Training (2023)		Multi-Tiered Approach: Classroom and School-Based Bullying Efforts (2022) Multi-Tiered Bullying Program that Engages Youth, Classrooms, and Schools (2022) Trauma-Informed Schools (2016)	School-Based Violence and Bullying Prevention Programs (2022) School-Wide Positive Behavioral Interventions and Supports (2022)

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Promising:

Clinical Tool for Youth Risk Screening and Health Education (MI; 2020)
Education, Universal Screening, and Services and Supports for Students (NC; 2021)

2. Think Upstream with Planning Tools—Lead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

3. Work Together with Implementation Tools—Move from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Find field-based resources focused on reducing bullying relevant to Title V programs in the MCH Digital Library.
Search the Established Evidence database for peer-reviewed research articles related to strategies for reducing bullying.
Request Technical Assistance from the MCH Evidence Center
MCH Evidence Center Frameworks and Toolkits:

Implementation Resources: Use these field-generated resources to affect change

Practice. The following tools can be used to translate evidence to action to advance this NPM:

Stop Bullying (stopbullying.gov). This website contains resources for parents, school staff, and other adults to help kids prevent bullying.
Implementation Toolkit for Bullying (AMCHP). This toolkit provides resources to complement strategies in the Assessing prevention capacity & implementing change: An evidence-informed and evidence-based bullying prevention capacity assessment and change package.

Partnership. The following organizations focus efforts on reducing bullying behavior:

STOMP Out Bullying®. Works to reduce and prevent bullying, cyberbullying, and other digital abuse.
PACER’s National Bullying Prevention Center. Seeks to create a world without bullying with multiple resources to take action.
National Association of People Against Bullying. Advocates for children who are bullied and their families to bring about positive resolution.

Additional Resources:

Preventing Bullying: The Role of Public Health and Safety Professionals (Children’s Safety Network).
Bullying prevention strategies and resources for K-12 schools (Schoolsafety.gov).
Data Resource Center for Child and Adolescent Health (DRC): A project of the Child and Adolescent Health Measurement Initiative, the DRC is a national data resource providing easy access to children’s health data on a variety of important topics, including the health and well-being of children and access to quality care.
StopBullying.gov: A federal repository of trainings, state laws and policies, information for schools, and guidelines for children and adolescents on bullying, cyberbullying, and prevention strategies.
Implementation Toolkit for National Performance Measure 9 (AMCHP). This toolkit contains examples of state strategies being used to address NPM 9 in Title V programs.
Rural Suicide Prevention Toolkit (Rural Health Information Hub). The toolkit compiles evidence-based and promising models and resources to support organizations implementing suicide prevention programs in rural communities.

References

Introductory References: From the MCH Block Grant Guidance

¹ U.S. Department of Health and Human Services. StopBullying.gov. (n.d.).

² Child and Adolescent Health Measurement Initiative. 2020-2021 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved 01/30/23 from https://www.childhealthdata.org/browse/survey/results?q=9586&r=1&g=1000

Evidence Tools Bullying